On June 4, 2025, private equity firm Avista Healthcare Partners announced the completion of its acquisition of EBI's bone healing division, marking the second change in ownership within two years for the company specializing in bone growth stimulation technology. Just a year prior, H.I.G. Capital acquired Highridge Medical, which included EBI, from ZimVie for $375 million.

EBI's Turnaround Begins Amid the Wave of Giant Strategic Adjustments. In March 2022, orthopedic giant Zimmer Biomet underwent a strategic reorganization, spinning off its spine and dental businesses into an independent company, ZimVie, which was then listed. However, after only two years of independent operation, ZimVie decided to "streamline" again.

At the beginning of 2024, private equity firm H.I.G. Capital acquired ZimVie's spine business, including its spine, motion preservation, and EBI bone healing product portfolios, for $375 million, restructuring it into Highridge Medical. However, just one year later, Highridge Medical spun off the EBI bone healing division separately, selling it to another private equity firm, Avista Healthcare Partners.

"The transaction will allow Highridge Medical to focus purely on spinal technology as a company," said Rebecca Whitney, CEO of Highridge Medical, in an interview ahead of the announcement. After the sale, the company’s workforce was streamlined from 713 employees to around 500, with an estimated revenue of approximately $325 million in 2024, accounting for about one-fifth of the original total income.

Avista, with substantial capital taking over EBI, has invested over $9 billion in 50 healthcare companies globally. The company appointed Kevin Kenny, former Global Spine President of Orthofix Medical, as the new CEO of EBI, hoping to revitalize this pioneer in bone healing technology by leveraging his extensive experience.

The global medical device industry is witnessing a wave of asset divestitures and spin-off transactions.

• Stryker:In April 2025, Stryker officially announced the completion of the sale of its U.S. spinal implant business to Viscogliosi Brothers, LLC (VB), an investment firm focused on the neuromusculoskeletal sector. The newly established VB Spine, LLC will operate as an independent entity and gain exclusive rights to use Stryker’s Mako spinal robotic surgery system and Copilot assistance system.
  

• Zimmer Biomet:In 2022, the spine and dental businesses were independently split to establish ZimVie, which, due to continuous losses, sold its core spine business to private equity group HIG Capital for $375 million in December 2023.
  

• Johnson & Johnson:Due to the growth bottleneck faced by the orthopedic business (DePuy Synthes), Johnson & Johnson stated during the 2023 Q3 financial report meeting that its medical technology division is restructuring the DePuy Synthes orthopedic business. The plan includes divesting low-margin product lines and focusing on surgical robotic technology.
  

• Smith & Nephew:Since 2019, Smith & Nephew's performance has gradually entered a period of weakness, especially in the orthopedics business, which has only maintained single-digit growth. After September 2021, affected by China's centralized procurement policies, the spinal business faced significant pressure, and the focus shifted to sports medicine and joint fields.
  

According to Wise Guy Reports, the global spinal medical device market size is expected to increase from $16.46 billion in 2024 to $24.3 billion in 2032, with a compound annual growth rate (CAGR) of 4.99%. Amid this growth outlook, structural changes are reshaping the industry landscape.

Growth Point Transfer

The market growth engine has shifted from traditional implants to new technology fields. Although spinal implants still account for more than 40% of the revenue in 2023, the growth momentum has given way to emerging fields.

Spinal cord stimulation devices are gaining popularity as a non-surgical treatment option for chronic pain management; artificial disc replacement is becoming a favored alternative to traditional spinal fusion surgery; and there is a surge in demand for advanced instruments such as robotic surgery systems.

Regional Market Differentiation

North America dominates the global spinal medical device market with high healthcare spending and advanced technology, followed by Europe, while the Asia-Pacific region is expected to become the fastest-growing market.

This regional pattern change is prompting companies to adjust their strategies. "Going overseas" has become a way for Chinese companies to break through. The scale of developed countries' markets is considerable, with stronger payment capabilities, offering greater profit margins for products made in China. Companies like Mindray Medical are actively expanding into international markets through cooperation with overseas distributors.

The Rise of the Refurbished Market

Refurbished Medical Equipment Market Becomes New Growth Point. A 2018 report shows that by 2020, the global refurbished medical market is expected to reach 10.4 billion euros, with a compound annual growth rate of 12% over the next five years.

Medical imaging equipment accounts for the largest share in the refurbishment market, with MRI and CT accounting for more than half of the global medical equipment refurbishment market share. Probo Medical, the largest ultrasound equipment refurbisher in North America, achieved an EBITDA of over 30 million US dollars in 2021, increasing by 275% compared to 2018.

Under the dual pressures of cost control and technological iteration, the spine business is undergoing value reconstruction. Private equity capital has become the main force in taking over, uncovering "hidden gems" abandoned by giants through professional operations.

After Highridge Medical sold EBI, it focused its resources on the core spinal business. "We are highly focused on increasing revenue," Whitney said, "We are officially back in the game to capture market share." The company's growth rate in the first quarter was twice that of other markets, and it strengthened its commercial team by recruiting competitive sales talent.

With the support of its new owner, independently operated EBI is expected to further deepen its technological advantages in the bone healing field. Newly appointed CEO Kenny stated, "We position EBI as the most innovative leader in bone healing science — providing solutions that improve patient outcomes."

Refurbishment and Value-Added Services Become Effective Strategies to Address Price Pressure. Probo Medical, through continuous acquisitions and expansion, now operates 14 facilities across the U.S. and Europe, offering a full range of services including refurbishment, sales, service, and repair of imaging equipment. This model provides cost-effective options for healthcare institutions facing budget constraints.

Technological breakthroughs remain the key to resolving challenges. Innovative companies like Yunnan Ophthalmic Biosystems, with groundbreaking designs such as the bridging composite internal fixation system (OBS), address industry issues like stress concentration and metal fatigue fractures. These breakthrough technologies inject new vitality into the spinal market facing homogenized competition.

The two sales of Highridge Medical essentially epitomize the global spinal market's transition from "scale expansion" to "value creation." For enterprises, whether adhering to core technologies, embracing capital integration, or focusing on niche markets, it is crucial to strike a balance between technological innovation, cost control, and strategic focus. Precisely grasping this balance is not only key to surviving through cycles but also the core strategy for building differentiated advantages amidst procurement pressures and global competition.

▲ Source of the article: Medical Device Innovation Network

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